Chronic Care Management

How to make $100,000 more per year.

Running a medical practice has been an extremely tricky venture – especially over the last 10 years. Balancing shrinking reimbursements and strict documentation guidelines with quality patient care has been tough. Fortunately, Medicare has heard these complaints. As of January 1st, 2015 providers can begin to bill for Chronic Care Management services. As with every new Medicare program, there are some requirements you have to meet to take advantage of this. Don’t sweat though – were here to simplify this for you.

In short, you have the ability to be reimbursed about $42 per month per Medicare patient. All you have to do is dedicate 20 minutes of time in direct coordination of care for that patient outside of the office – think follow-up phone calls and medication reminders. These patients do need to have at least 2 qualifying chronic conditions to be included though.

Now, I know what you are thinking, “$42 dollars does not sound like all that much”. Trust me, I know – I thought the same thing. However, when you begin to do some simple math it all starts to add up. The AMA estimates the average provider has roughly 500 Medicare patients. Of these, usually two-thirds of the population have two or more chronic conditions that would qualify for these services. So, is it worth it?

500 total Medicare patients * 2/3 population with 2 or more qualifying conditions = 330 qualifying patients
330 qualifying patients * $42 Medicare payment = $13,860 per month
$13,860 per month * 12 months = $166,320 per year.

Ok, now are you with me? $166 thousand is no small fee considering that is just shy of the median salary for a full time family physician. Now, let’s look at the time required to make this happen.

330 qualifying patients * 20 minutes per month = 6,600 minutes per month
6,600 minutes per month/ 60 = 110 hours per month
110 hours per month/ 20 business days per month = 5.5 hours per business day

Again, I know what you are thinking – I don’t have an extra 5-6 hours each day either. The good news is that it does not necessarily have to be you providing the service. Your staff can coordinate most of the care for you. You do have to be available 24 hours a day/ 7 days a week in case of an emergency and you are ultimately responsible for your staff’s work. At this point in time, I am asking myself, “Is it worth it? I would have to hire a full time employee just to keep up!” My answer to that would be “Yes” and “Do it now!”

$166,320 per year - $35,000 per year (median hourly pay for a medical staff member) = $131,320 yearly profit

Let’s assume that you do have to commit some of your own time to this care along with other administrative tasks like actually submitting the claim – you are likely to spend another $30,000 in these endeavors. When it is all said and done, you stand to add on an additional $100,000 per year. Even better – your patients will have another avenue to ensure their own health.

Like what you see? Are you interested in learning more? Seem tough? Not interested in taking the time? There are other ways to profit on this and DO ABSOLUTELY NOTHING.

Additional Reading
Profit from Chronic Care Management without actuallying doing anything.
Step-by-step guide to billing Medicare for Chronic Care Management Services.


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